Free Hospital EMR and EHR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to Hospital EMR and EHR for FREE!

Lessons Learned from the 2017 AHIMA Information Governance Survey – HIM Scene

Posted on May 16, 2018 I Written By

The following is a guest blog post by Stephanie Crabb, Co-Founder and Principal at Immersive as part of the HIM Scene series of blog posts.

The American Health Information Management Association (AHIMA) 2017 Information Governance (IG) survey follows previous surveys administered in 2014 and 2015 to identify trends and offer insights associated with the healthcare industry’s understanding and adoption of IG. The good news from the 2017 survey is that awareness of IG, at least among the 1500+ survey respondents, is high with 84.6 percent reporting that they are familiar with IG. The bad news from the survey is that 51.6 percent of those same respondents report that lack of awareness or misunderstanding of IG is a barrier (the most significant barrier reported) to IG adoption in their organizations.

Who participated?

While the 2017 survey garnered more participation from outside the health information management professional community than previous efforts, it is important to note that the majority of respondents identified themselves as health information managers (HIM-ers). AHIMA’s work to raise IG awareness and educate the healthcare industry since 2012 has been significant and is to be commended. The body of knowledge created and published and the work completed is extraordinary; it has certainly paid off with its own constituents. Perhaps the survey demonstrates that there is still work to be done with additional stakeholders or that we need to do more to demonstrate the knowledge and capabilities that HIM-ers possess to support IG efforts.

IG Adoption, Drivers and Benefits

Based on what we see, read and experience, in every sector of the industry information and the data from which it is created are at the center of nearly every strategic and tactical activity. So why the disconnect, or the slow pace of formal IG adoption? Why did only 14.8 percent of respondents report an “initiated” IG program as illustrated below? Further, why did percent of respondents report that IG is not considered a priority in their organizations?

A closer look at what respondents had to say about the barriers to IG adoption is useful. The survey offered respondents a list of commonly-cited barriers to IG adoption across all industries and asked them to select their top three, resulting in the following:

For many, the term “governance” implies bureaucracy, expense, complexity, misplaced power and control, among other negative connotations. This may offer some context for these survey results and explain, in part, the top responses.

IG is a complex discipline, no doubt. However, everyone can identify IG or IG-like work that is getting done in their organization every day; it is just not formalized, organized or recognized as such. Sadly, much of that work is buried or siloed, in part, because it is not connected to a strategic imperative where it might gain greater visibility and appreciation as an IG effort.

The data around low IG adoption are even more confusing when we look at what respondents had to say about what they think does or should drive IG efforts. The survey demonstrates that there is no shortage of compelling and meaningful drivers to spur action. While the survey did not provide respondents with the same response choice options for “drivers” and “benefits” there was a connection and association reflected in the responses to these two questions.


These responses reflect an impressive number of business units, departments and individuals–workforce and patients—that can truly be served by and through IG.

What’s Changed from 2014 to 2017?

In 2014, 43% of respondents reported that a formal IG program had been initiated compared to 14.8% of respondents in 2017. What contributes to this dramatic change? Does it reflect organization abandonment of previously initiated IG efforts? Does it reflect that respondents are more educated today so what they labeled as IG in 2014 was not really IG? This area may warrant further exploration in future survey efforts.

In 2014, respondents cited “strong agreement” with regulatory compliance (80 percent), improvement in patient care and safety (73 percent) and the need to manage and contain costs (61 percent) as the top three drivers for IG, followed by analytics and business intelligence (53 percent). Interestingly, trust and confidence in data was the lowest rated driver. In 2017, data quality and trust ranked second. Analytics and business intelligence tops the list of drivers, patient safety falls to the middle and regulatory compliance is at the very bottom of the list.

The most promising insight from the 2017 survey is that data governance (DG) is a growing priority and reality in healthcare. Thirty percent of respondents reported a “formal structure” for DG in their organization. There is still a bit of confusion between IG and DG as disciplines. DG is one of the competencies in AHIMA’s IG Adoption Model and often referenced as a sub-domain of IG in other reference models. Simply stated, data are the building blocks of information, so DG is requisite to IG. One takeaway from the survey is that healthcare organizations are progressing along a path that positions DG as a precursor to IG, rather than a component of IG.

Conclusion

While the drivers for IG seem to have shifted over the time that AHIMA has spent surveying the industry, there is a universality to the vision and expectation that healthcare wants and needs to put its data and information to work to accomplish its ambitious and complex mission. Much of AHIMA’s and its IG partners’ work to document the experiences of IG pioneers is available at IGIQ.org.

Have ideas about how we can better study the topic of IG and deliver meaningful insights to you? Please share your comments.

About Stephanie Crabb
Stephanie is Co-Founder and Principal at Immersive, a healthcare data lifecycle management company where she leads program and solution development, knowledge management and customer success. Stephanie brings 25 years of experience in the healthcare industry where she has served in program/solution development, client service and business development roles for leading firms including The Advisory Board Company, WebMD, CTG Health Solutions and CynergisTek. She has led a number of program and product launches with an emphasis on competitive differentiation, rapid adoption, client satisfaction, and strategic portfolio management.

Prior to her work at these firms Stephanie worked for a large Maternal and Child Health Bureau grantee working on the national Bright Futures and Healthy Start initiatives to develop and document best practices in the care continuum for pediatrics and infant mortality, and to inform federal and state health policy initiatives in these areas.

Stephanie holds her A.B. and A.M. from the University of Chicago. Stephanie serves as the Scholarship Chair of CNFLHIMSS, on AHIMA’s Data Analytics Practice Council and recently completed a two-year term on the Advisory Board of the Association for Executives in Healthcare Information Security (AEHIS) of CHIME.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Coding Accuracy: Study Reveals Differences Between Domestic and Offshore Coding – HIM Scene

Posted on March 23, 2018 I Written By

The following is a guest blog post by Bill Wagner, CHPS, Chief Operating Officer, KIWI-TEK.

In January 2015 the ICD-10-preparation frenzy was at its peak. Healthcare provider organizations were scrambling to find coding support during the implementation and transition phases of the quickly approaching ICD-10 implementation deadline. KIWI-TEK was one of those outsourced coding companies being asked to supply experienced, qualified coders.

KIWI-TEK was valiantly trying to keep up with the burgeoning client requests for coding support. And although they had been actively recruiting for months, their coding bench was empty. For the first time in company history, KIWI-TEK decided to augment their team with additional coding resources by contracting with several offshore coding services.

By April 2016, the crunch for additional coding support was all but over. However, the appeal of lower coding costs via offshore coding support drives many healthcare executives to contract with international outsourced coding support. Interest in offshore coding remains even to this day as evidenced by Partners Healthcare recent decision to outsource medical record coding to India.

But what about coding accuracy? This question remains and HIM Directors deserve a data-driven answer.

The Study

Until now, the only information available for providers to compare outsourced domestic coding quality with offshore coding performance was anecdotal. Specific quality data had not been produced or shared. Amidst rampant questions and red flags, KIWI-TEK partnered with six hospitals and health systems to answer the coding industry’s toughest question: “Who delivers higher coding accuracy, domestic or offshore outsourced coding services?” (Be sure to check out the full study results for a more detailed answer to this question).

Each of the six participants had experience with both domestic and offshore coders for at least one year. The same onboarding, auditing, and training procedures were applied equally to all.

Code Accuracy Lower with Offshore

Across all six organizations, code accuracy was lower for the outsourced offshore coding service versus the domestic coding companies by an average of 6.5 percentage points.

Poor coding quality also increased payer denials with additional management time required to onboard, train and audit the outsourced offshore coders.

And What About the Cost?

The final results showed that, despite what seems to be a much lower hourly rate for offshore coders, the total cost is much higher when all factors are taken into consideration. These factors include:

Auditing – Offshore coders required an average of 6 more hours per coder per month of auditing due to poor accuracy results.

Denied claims – Offshore coders averaged 10 more denied claims on Inpatient and Same Day Surgery encounters per week than domestic coders. Reworking of denied claims on these patient types takes 40 minutes for each claim.

The Final Answer

Yes, there is a difference. Offshore coding is less accurate, and in the long-term, may also be more expensive.

To read detailed findings of the study, download the KIWI-TEK White Paper entitled “Is Offshore Coding Really Saving You Money”.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.  KIWI-TEK is a proud sponsor of Healthcare Scene.

An HIM Perspective of What Was Shared at #HIMSS18 – HIM Scene

Posted on March 9, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today is the final day of the HIMSS 2018 Annual Conference. While there are nearly 44k attendees at the conference and 1350 vendors, I didn’t meet a single HIM professional. I certainly didn’t meet all 44k attendees, but it’s safe to say that the HIM community wasn’t well represented at the HIMSS conference. It’s unfortunate because healthcare IT initiatives can really benefit from the HIM perspective.

Since many HIM professionals weren’t in attendance, I thought it would be beneficial to share some insights into trends I saw at HIMSS 2018 that could be beneficial to HIM professionals.

AI (Artificial Intelligence)
AI was the hottest topic at HIMSS 2018. It seemed like every vendor was saying that they were doing some sort of AI. Of course, many used the AI term very broadly. It included everything from simple analytics to advanced AI. In some ways, that’s corrupted the term AI, but what’s clear is that lots of companies are using data to provide insights and to automate a wide variety of healthcare work.

Another great insight I heard was that revenue cycle management and other financial areas are a great place to start with AI because they’re seen as less risky. When you’re applying AI to clinical use cases, you have to worry a lot more about being wrong. However, the consequences aren’t nearly as damaging when you’re talking about the financial side of healthcare.

Information Governance and Clean Data
At HIMSS 2018 I heard over and over the importance of having clean data. If AI was the hottest topic at HIMSS 2018, none of that AI will really matter or provide the value it should provide if the data is inaccurate and not trusted. This is why the work that HIM professionals do to ensure effective information governance is so important. It’s almost cliche to say bad data in leads to bad insights out. However, it’s cliche because it’s true. HIM needs to play an important role in making sure we have accurate data that can be trusted by AI applications and therefore the providers that receive those insights.

Texting Patients Is Not a HIPAA Violation
No doubt this will feel like news for many of you. It may even scare many HIM professionals. However, OCR Director Severino made it clear that Texting Patients is Ok. I won’t dive into the details here, but read the article by Mike Semel which outlines what was said at HIMSS 2018 in regards to texing patients.

Healthcare Chatbots
I didn’t see any healthcare chatbots that are solving HIM’s problems. However, when you look at the various healthcare chatbots out there, there’s no reason why a healthcare chatbot couldn’t do amazing things for HIM professionals. Here’s a framework for healthcare chatbots that companies should consider. What mundane tasks are well defined that could be automated by a healthcare chatbot? When you ask this question, you’ll see how chatbots are something HIM professionals should embrace. There’s a lot of mundane HIM work that could be done by a chatbot which frees them to work on the more challenging HIM issues.

Patient Access to Medical Records Is No Longer Controversial
While some specific individuals have fears related to access to medical records, it’s been proven across every type of healthcare organization that providing patients’ access to their medical records is right thing to do. The fears people have are unfounded and that patients find this extremely valuable. I heard one person say that they no longer will do visits with doctors who will not give them access to their records.

Those were some high level insights from a HIM perspective. Lots of exciting things when it comes to technology and HIM. What do you think of these changes, announcements, and trends? We’d love to hear your thoughts and perspectives in the comments.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

The Full Spectrum of Information Governance – HIM Scene

Posted on February 7, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Information governance is such an important topic across so many areas of healthcare. It impacts almost every organization and quite frankly takes the full organization to buy in to ensure proper information governance. Doing it right is going to be essential for any healthcare organization to work efficiently and effectively in the future.

While information governance impacts everyone in healthcare, I have to give credit to AHIMA and their HIM professional community for leading the way on the topic of information governance. A great illustration of this leadership is in the AHIMA Information Governance Adoption Model Competencies (IGAM):


*Thanks to HIM professional, Katherine Downing for sharing it on Twitter.

I think a lot of people that work in a hospital and healthcare system don’t recognize a lot of these areas of information governance. At least they don’t look at them from that lens.

My favorite part of this model is that it starts with creating the right information governance structure and the strategic alignment. If you don’t get the right people assigned as part of their job to work on information governance, it will never happen. Plus, if you don’t realize how information governance aligns with the organizations priorities, then you’ll fall short as well.

How far along are you in your information governance efforts? Have you incorporated all of the above elements into your information governance strategy? We’d love to hear your experiences, insights, and perspectives in the comments.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Looking Forward to #AHIMACon16 – HIM Scene

Posted on October 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

As we prepare to head to the 2016 AHIMA Annual convention (see our full list of conferences we attend), we’re excited to talk about how we’re planning to expand HIM Scene to include as many HIM voices and perspectives as possible. HIM Scene will still be hosted here on Hospital EMR and EHR and will still have its own email list where HIM professionals can receive great HIM related content from thought leaders across the industry. However, we’ll be using HIM Scene to share a wide variety of people and perspectives.

The HIM industry is an amazing group of devoted people and that really comes through at every AHIMA annual convention I attend. Plus, HIM has a lot more influence than many people realize. So, we’re happy to do what we can to raise the voices and perspectives of HIM professionals here at HIM Scene.

Looking forward to the AHIMA Annual convention next week in Baltimore, we’re excited to learn about a number of important topics. Here are a few we’ll be sure to report on in future HIM Scene posts:

ICD-10 – A year after implementation, I’m really interested to hear the real stories of how ICD-10 has impacted healthcare organizations for good and bad. I bet there will be a lot of stories that haven’t been shared. I’ll also asking the HIM professionals I meet what they think the impact of the end of the ICD-10 grace period will have on healthcare. I wonder how many will have stories of ICD-10 improving care versus stories of ICD-10 for reimbursement.

Information Governance – This is an eternally hot topic in HIM, but it always continues to evolve. This is particularly true as records have gone electronic. This year I wonder how many people have been involved in some sort of health data sharing project. Information governance can get pretty tricky as healthcare organizations start to share data with each other electronically.

HIPAA Privacy and Security – A really hot topic given all the HIPAA breaches and ransomware incidents in healthcare. I’m sure I’ll find a number of HIPAA privacy officers that will share some good insights into how they’re dealing with these security and privacy challenges. I’m afraid many of them will give me exasperated responses about how their leadership isn’t taking it serious enough.

Informatics – I’ve been really intrigued with HIM’s role in healthcare informatics. Once you dive in, it makes since why HIM would be involved, but I don’t think most people saw that at first. What’s also been interesting to watch is many HIM professionals who’ve kind of shunned their involvement in healthcare informatics. We’ll see if many are still in that position or if most HIM professionals are starting to embrace and participate in the informatics efforts of their organizations.

What hot topics will you be looking for at the 2016 AHIMA Annual Convention? The AHIMA 2016 theme is to “Inspire Big Thinking to Launch Our Future.” We’ll be sure to report back any big thinking we hear from people we meet.

ahima-2016

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

What’s Information Governance and Why Does It Matter in Healthcare?

Posted on August 19, 2015 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

I recently spent some time explaining Information Governance (IG) and its importance to one of our executive leaders. She asked me to explain IG in 3 sentences or less to help her understand. Well, that was actually pretty difficult. It is complicated to summarize such a large, all encompassing framework that is IG but I believe I made the case effectively: “Information Governance is the umbrella that houses every transaction of information (not just medical records) within the organization and covers many different departments and tasks. It is much more than data governance. IG covers everything from monitoring the generation of data, protecting the information, controlling access to information, capturing revenue, governing the content and quality of the information, promoting population health, making decisions from data, and sharing the information internally and externally.”

Perhaps my explanation was less concise than she was looking for but IG is just that complex. I was happy to have the floor and to be able to discuss this topic with someone who can help me make an impact within the organization with a little education and guidance. I did not wait to be asked about IG. This topic is something of importance to me as an HIM professional and it’s also important to the successful operation of healthcare therefore I look for ways to insert the topic into everyday conversation at my organization. I welcome the opportunity to discuss IG.

This concept of governing information is not new; especially not to HIM professionals. Healthcare IG is becoming the new brand for the tasks we have done in HIM for decades. As more and more health information has become automated, IG has emerged as the necessary solution to the growing presence of raw data and increased electronic accessibility. I agree that governing health information and data in an electronic world is different from the paper-based records of the past but the foundation and concepts are the same. Managing information in the form of thousands of pieces of data takes technology and data analytics skills that HIM professionals are adapting and learning every day. We must take the new technology and the wealth of data and use it for the good of healthcare.

IG is really not so daunting when you start to apply it to everyday organizational workflows. It’s what HIM professionals know best. AHIMA has adapted ARMA’s generally accepted recordkeeping principles and has written a collaborative white paper to help us better understand what IG is in today’s data-driven healthcare environment. This is great for educating the HIM workforce and creating talking points for discussing IG within our organizations. If senior leaders and other healthcare professionals don’t understand IG and why an organization needs a structured approach, it is up to HIM professionals to start the conversation to introduce everyone to the principles of information governance and how HIM can lead the cause.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.